This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by DeGroote, R. D. Articles by Hobson, R. W. Search for Related Content PubMed PubMed Citation Articles by DeGroote, R. D. Articles by Hobson, R. W., 2d

Stroke, Vol 18, 1031-1036, Copyright © 1987 by American Heart Association

ARTICLES

Carotid restenosis: long-term noninvasive follow-up after carotid endarterectomy

RD DeGroote, TG Lynch, Z Jamil and RW Hobson 2d
Department of Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark.

Recurrent stenosis has not been a primary consideration in the selection of patients for carotid endarterectomy. We have studied the incidence of postoperative restenosis retrospectively in 265 patients following 310 carotid endarterectomies. Two hundred fourteen patients (248 endarterectomies) were examined at 6-12 month intervals using ocular pneumoplethysmography, spectral analysis, and B-mode imaging. The absolute incidence of recurrent carotid disease was 28% (69 of 248), with a 13% (33 of 248) incidence of hemodynamically significant restenosis and a 15% (36 of 248) incidence of hemodynamically insignificant disease. Life table analysis of the data projected a 32% incidence of hemodynamically significant restenosis after 7 years and a 40% incidence of hemodynamically insignificant recurrence. These data demonstrate a progressively increasing rate of restenosis. The incidence of ipsilateral neurologic events was 8% (24 of 310); 12 occurred in association with noninvasively evident recurrent disease (12 of 69, 17%), whereas 11 occurred in noninvasively determined normal arteries (11 of 179, 6%). Noninvasive follow-up was not available in 1 patient. Of the 12 events associated with recurrent disease, 5 occurred in association with hemodynamically significant restenosis (5 of 33, 15%), whereas 7 occurred in association with hemodynamically insignificant disease (7 of 36, 19%). Carotid endarterectomy is a durable operative procedure with 92% (286 of 310) of arteries remaining asymptomatic over the period of clinical follow-up. However, absolute and life table projections of the incidence of asymptomatic restenosis are high, and this factor should be considered in the selection of patients for carotid endarterectomy, particularly in the absence of lateralizing symptoms.

This article has been cited by other articles:

				B. K. Lal Cognitive Function After Carotid Artery Revascularization Vascular and Endovascular Surgery, February 1, 2007; 41(1): 5 - 13. [Abstract] [PDF]

				A. M. Malek, R. T. Higashida, C. C. Phatouros, T. E. Lempert, P. M. Meyers, W. S. Smith, C. F. Dowd, and V. V. Halbach Stent Angioplasty for Cervical Carotid Artery Stenosis in High-Risk Symptomatic NASCET-Ineligible Patients Stroke, December 1, 2000; 31(12): 3029 - 3033. [Abstract] [Full Text] [PDF]

				C. D. Liapis, J. D. Kakisis, V. G. Papavassiliou, K. M. Koumakis, and J. G. Gogas Risk Factors Associated with Recurrent Carotid Artery Stenosis Vascular and Endovascular Surgery, November 1, 1999; 33(6): 697 - 704. [Abstract] [PDF]

				A. Mezzetti, M. D. Guglielmi, S. D. Pierdomenico, F. Costantini, F. Cipollone, D. De Cesare, T. Bucciarelli, S. Ucchino, F. Chiarelli, F. Cuccurullo, et al. Increased Systemic Oxidative Stress After Elective Endarterectomy : Relation to Vascular Healing and Remodeling Arterioscler. Thromb. Vasc. Biol., November 1, 1999; 19(11): 2659 - 2665. [Abstract] [Full Text] [PDF]

				H. Frericks, J. Kievit, J. M. van Baalen, and J. H. van Bockel Carotid Recurrent Stenosis and Risk of Ipsilateral Stroke : A Systematic Review of the Literature Stroke, January 1, 1998; 29(1): 244 - 250. [Abstract] [Full Text] [PDF]

				K. A. Plestis, Z. Jiang, H. Appel, and J. F. Howell Treatment of Recurrent Carotid Disease: Report on a 12-Year Experience Vascular and Endovascular Surgery, November 1, 1997; 31(6): 693 - 702. [Abstract] [PDF]

				S. P. Tripathi and N. Deshmukh Early Restenosis After Carotid Endarterectomy with Vein Patch Angioplasty Vascular and Endovascular Surgery, November 1, 1997; 31(6): 761 - 767. [Abstract] [PDF]

				P. V. Petrik, H. A. Gelabert, W. S. Moore, W. Quinones-Baldrich, and M. M. Law Cigarette Smoking Accelerates Carotid Artery Intimal Hyperplasia in a Dose-Dependent Manner Stroke, August 1, 1995; 26(8): 1409 - 1414. [Abstract] [Full Text]

				L. K. Birinyi and F. W. Logerfo Intimal Hyperplasia: Evolving Concepts of Pathophysiology and Therapy Perspectives in Vascular Surgery and Endovascular Therapy, January 1, 1989; 2(2): 97 - 111. [PDF]

				R. W. Hobson Asymptomatic Carotid Stenosis: Current Diagnosis and Management Perspectives in Vascular Surgery and Endovascular Therapy, January 1, 1988; 1(1): 141 - 154. [PDF]